39A-76 (52) 9r`telsrr`#2' 't`aitYttesmETlto.. BP-2002-0213
GIS#; 0 r COMMONWEALTH OF MASSACHUSETTS
,L
39A07& ;15 CITY OF NORTHAMPTON
Lot -et.'
Permit: Building
Ca .
tegory:Non structural interior renovations BUILDING PERMIT
Permit# BP-2002-0213 .
Project# JS-2002-0335
Est.Cost$8580.00
Fee:$;;0.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor License:
uses) DONALD GUERIN 077913
Lot Silg(sq. ft.): 66211 .20 Owner: OUICKBEAM REALTY TRUST
ZonSne.GB Applicant: DONALD GUERIN
AT: 492 PLEASANT ST -FORMERLY CLUBMETRO
ApplicantAddress: Plunge: Insurance:
10E21/2 MAIN,,,$T (413) 533-3727 Workers
Compensation -.
H O LY O KE M A01040 ISSUED ON:8/31/01 0:00:00
TO PERFORM THE FOLLOWINGWORKNEW BAR COUNTERS, REM HANDICAP RAMP
TO UPPER STAGE,REMOVE TUNNEL, REMODEL MENS/LADIES RM
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. - Inspector of Buildings
Underground: Service: Meter:
Footings:
Ron : Rough: House# Foundation:
/,21 C OAT
F7nsj:/� Final: /0/1(4, -grfF
�� Rough Frame:
Gas Fire Department Fireplace/Chimney:
tombs)vY 0 i / w?1E/<: t n
Rough: nil: rive k I<goil, + & 1SLI - 2..4V nsulation: A'
Final: Smoke: Final:ex r e-/SYCJ
i a •— -.!: r1-.,:i t ._,.:A!ru
THIS PERMIT MAY BE VO I t ` r TP OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
..,r �.{
Certificate of Occupancy -- O ature:uA Edi _-4
Fee Type: Receipt No: Date Paid: Check No: / Amount:
Building 8/31/010:00:00 302 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2002-0213
APPLICANT/CONTACT PERSON DONALD GUERIN
ADDRESS/PHONE 1062 1/2 MAIN ST (413)533-3727
PROPERTY LOCATION 492 PLEASANT ST-FORMERLY CLUBMETRO
MAP 39A PARCEL 076 001 ZONE GB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out J'1
Fee Paid �3dct? t ` o
Typeof Construction: NEW BAR COUNTERS,REM HANDICAP RAMP TO UPPER STAGE,REMOVE
TUNNEL,REMODEL MENS/LADIES RM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 077913
3 sets of Plans/Plot Plan
THE FOL OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION PRESENTED:
Approved Denied
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan OR Special Permit and Site Plan
Major Project: Site Plan OR Special Permit and Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission
3/-o/
Signature of Buildin ictal Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
"Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
Version l.7 Commercial Building Permit
ermit May 15,2000 000
11 orthampton ?so: .•-• a to 2 V . Department t � Asr e, I rif
a,ri [. -
Sain Street ,r aa •t�r e nS _
AUG 2 4 2fC1 'mloo r� nnllk
\
ort : p on, MA 01060 .9 ;fitr t}-.E ^
.4.2 - 4 - : 7-1440 Fax 413-587-1272 i rTeK z�,l
DEPT OF BUILDING INSPECTIONS
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION ( //
1.1 Pro e A ess: / �C�Icb /'KC`be0� <:. Thiss sesctioorr_to be completed by office ,
(� -jl" /-fir �/,/�
W 2 oIjr+4v ? _MO ., fid 11:0,4t7 son-�a.Gvt',, un�,et-
S
r
/- /�� 6 , /"'� - Zon Overlay District }•
Elm St.District CB District
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 8444I 1
2.1 Owner of Re rd: c2 R• W{'
���n/,,
Name(Print) Current Mailingdress.
! a a d ' 92! 3sa-31sl
Signature Telephone
2.2 Authorized Agent:
— Current Mailing Address:
AP
Signature Telephone
SECTION 3-'ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 4i �' n (a) Building Permit Fee
2. Electrical !+" (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 +2 + 3 +4+ 5) Check Number 3d 2- 850 —
This Section For Official Use Only
Building Permit Number: 7/1-6 e) "d / 3 Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
P
x - Version1.7 Commercial Building Permit May 15,2000
c'0 rON5T3tUQ11014 SEi:iRVICCES FOR PRQJECTSLESSTHAN 35 OOil
4't] IANCLOSED` eE n
A.n
Interior AlteratiopL —ixisting Wall Signs Existing Ground Signs Additions 0 Roofing 0
❑ 0
Exterior Alterations Demo€ition❑ New Signs [ ] Change of Use [ ] Other [ ]
❑ �4 .� Accessory Building[ ] I Repairs [ ]
^�r�,� tai ii7'ekert +.,, FF4 di C%aT .e '-44a "%/ r'e Cr�,aQ .0/,r�/<=.
B64- a -zpTray%)• cm . en- .Q�-i.. r.r i t - !/.. h,
zSECTtONG.n.USE GROOU AND CONSTRUCTIO TYPE r„
USE GROUP(Check as applicable) CONSTRUCTION TYPE _
A Assembly I A-1 0 A-2 0 A-3 0 1A 0
A-4 0 A-5 0 1B ❑
B Business 0 __ 2A 0
E Educational 0 ..... 28 I ❑
F Factory 0 F-1 ❑ F-2 0 2C _ 0
H High Hazard 0 3A ❑
I Institutional 0 I-1 0 1.2 0 1-3 0 3B 0
M Mercantile 0 4 0
R Residential 0 R-1 0 R-2 0 R-3 0 5A 0
S Storage ❑ s-I o S.2 0 5B 0
U Utility 0 Specify:
M Mixed Use 0 Specify:
S Special Use 0 Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
jetthIONle BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION -,7 acv,,4 a:.l „lIf +a'.
Floor Area per Floor(sf) 1"
2d
tit .
FIA
E x
3rd
'''''Ii z
iiwai To{al Area(sf) Tr,tal Proposed New Constmetion(sf) z1 ..
Total Height(ft)
4
Total Height ft
Versionl.7 Commercial Building Permit May 15,2000
7. Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone 0 Municipal 0 On site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds? - -
NO DONT KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location: _.
D. Are there any proposed changes to or additions of signs intended for the property?YES
No
IF YES, describe size, type and location:
Version1.7 Commercial Building Permit May 15,2000
SECto. O6 S51 AL DESIGN ANabNSTRUCTION:SERVICES. R$UILDNGSSDsTRucTURES StEt ECT.FO•CONST &ITRL'PURSUANT tO")SOCMR 116(CONTAINING' ORETHANROCOCF.CF'ENCLOSE
PACE)'' ..C.
9.1 Registered Architect:
Not Applicable 0
Name(Registrant):
Registration Number
Address
Expiration Date
Signature Telephone
92 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Tei hone
_....... ep Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name
Area of Responsibility
Address Registration Number
Signature
__ Telephone Expiration Date
9.3 General Contractor
Company Name: Not Applicable O
Responsible In Charge of Construction
Address
Signature Telephone
p- __
Versionl.7 Commercial Building Permit May IS,2000
,Rren: '
Independent Structural Engineering Structural Peer Review Required Yes 0 No 0
SECTjopl�33s-OWNER;AUTNORIZATION TOtBECOMPLETED WHEN
OWNERS AGENT ORtONTRAOTOR APPLI f.bR p1QDiNO PERMIT
, as Owner of the subject property
hereby authorize to act on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
, as Ownerguthorized Agent
hereby declare that the statements and information on the foregoing application are true and accurate, to the best 6f-my
knowledge and belief.
Sign oder the lair a2d penalties/ of perjury.
04.4.-rtl (1 (A 64,=.2.
Pri . . .
AI. . 6
Signature of Owner/Agent Date
SECTION 12-CONSTRUCTION SERVICES.
10.1 Licensed ConstruciioaS�r { I Not Applicable 0
Name of License Holder: ✓N 6rCG6 2/ i t3
License Number
6 / _ 4/ t . x y/d6 a/om 1 L' l
dress _ Expiration Date
C/--- 533 7 cc"
�/' 3 7.1—
Signaiare Telephone
,SECTION 13 -WORKERS'COMPENSATION INSURANCE AFFIDAVIT;(M.G.L.c.152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavi'.
will result in the denial of the issuance/of the building permit.
Signed Affidavit Attached Yes 13 No 0